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Home My WebLink About20165773 - PermitCity of Santa Ana Permit Counter: (714) 647-5800 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 Electrical l nspection Requests: (7 1 41 667 -27 38 l nspector Section: (7 1 4) 647 -5853 Permit #: 2fJ165773 Pin #: 24792 Project Address: 4125 W Wisteria Pl U nit: Block: NA Bldg: Tract: 3656 Address Range: Historic: No Suite Range: Zoning: Rl q Assessor'sParcel:'188-101-16 Lot. l6 Owner: Address: Contractor Address: Abelardo Sicairos 4125 W- Wisteria Place Santa Ana, CA 92704 (714) 839-7598 Amount 51 .29 21.25 52.98 Fee $51.29 $21.25 $52.98 Qty 1.00 1.00 1 .00 0l{ iEe: tIYH Tr(tnE+: 4fir.it,+: REI+: tirp t.+ r r:r??l:;l7u -'i/2/lttlg tD: 2n 1t 12144 $1i7. State Lic #: Lic Type: Bus. Lic #: Workers' Compensation lnsurance Carrier: Policy #: Expires: ir (r sqct ion Total rrlie ltlrd0 S ic( inc,s rrnrirfll ['10n l]pd(ltE FEe -lI I I6rlr:r2- 516|]Ur]UU- : t'ii:tr icol rl 1 16( 12- i16r:r3rl[rJ- i:a:+ | x r. * x x rr*iI* *r l4 j Planning Conditions: Planning Approval By: Plan Checked By: Permit lssued By: Subject to Field: Building Permit #: Single Family Dwelling Miscellaneous Service Meter Occupancy: Constr Type Code: R-3, U VB cEc 2016 Chavez, Dave Every permit issued shall become invalid unless the wo* on the site authoized by such permit is comnenced wlhin 180 days aftet its issuance, or if the wotk authoized on the sito by such pemit is suspended or abandoned for a period of 180 days aftet the time lhe wo* is commencod. 05lo2l201a Account# Notes: Service meter upgrade. Owner-Builder form on file Handout given. $ 125.52 $0.00 $125.52 Date Date Date Misc. Receipt: Misc. Receipt: lVisc. Receipt: Total $2',1.25 $104.27 lnspector MID#: 2018-143122 0'1 116002 51600 0't 1 '16002 51603 Fee Total: Paid to Date: Balance Due: Fee Type 0'1 1 '16002 5'1603 Serv Nleter 01116002 51600 General Plan Update 011 16002 51603 lssuancePhone: Tenant Name: Owner-Builder Phonel Auth+ru;rrr,J Building Use: Job Type: Nature of Work: ELECTBICAL.INSPECTOR RECOFD APPROVALS DATE IDiSIG.COMMENTS OWNER BIIILDER DELCARATION I hcrcby alfifln u rr pcnalry of lcrjury fid I amcxcm t'ron the C.nr!.hn Li.cnsc Low lor thr following rcusn (S(.1r:11.5 Busin.ss and Profcsion Cdc): A.y Cny or Counr, which rcqltes ! pcmn r. .onstud. .11tr, improlc &mlish or rcplt lny stu.rtrrc, Jrior ro irs issxrncc, d{o r.quircs lhc lp/i.Mr rorsuch l*rnln b filca siSncd inrcmcnl thrr lEor shc n lienscd luBuunr ro rhc povirio.s oa rhc C.nrEcrofs Lac.n*d hw (Chlprd 9. Conm.Ning wirh scc'ion 7000 ol Division I ofrhc Businc$ and Pmlcsions codc)or rhal hc or shc is excm lncRfrom aftl rhc &st for r hc .llqcd cxcnprion. Any violari.i of SNrb. 701I 5 by ,ny applicanr f{, a l].mir suhjccrs rh. {nnli.r b acivilpcnalryofnor m* rhdn fivc hundrcd dinles ($5iJ0) ;p$' .**, r ,h. p-1"ny. or m) c,nf roirc\ I h wJF.\,s rhcr src m,n[lclvrnn. $,.. d. rk *nrr M rhc vo m h nitr ',;rcno"a - nnt,"a r* -t ri<.7r,44- 8;sircs ond Pnlasmns code: Ttu c;.teld\ Licne tis dm3 n r .rply ro 0n owrc' .r llE pn)pcdy wb blilds d i;{mrcs rhcBnr. Md who d$s such m himsclior h-isctror ihmlgh hh or h.r own.mpbyrc\. ,bvidcd rhd ruch inpmkftnk m mr inrcfrldl d ofi.rcd for slc ll ho*rw. lh. hoildin8 or iq,mrcmnl is sld virhin om )@ of comptrion. lhc Ourcr Builds will harc rlE hrdcn of lmvitrs lh.1 lE or ste dil mr hoild o, in{ftk nE ImFny ror 0E !,uq$s ofr' Lasown$.rrhcptundy..ncrclusivclyco.r,dingsirhlicctr*d.onr.ctortoconslrucllhcnojccr(Scc70'.l,Bt\i"r\\ and Pmnasion Codc: Thc Conllrcxtr s Li.ctrsc Ltrw do$ noi nptly lo trtr owncr otpDpcn, who huildr or inDrovcs lhcrcon. and who mnrd.ts fo! su.n rn+cls with d Contradons) liccn{d purua nrrhcConkr.tnst -l ucxcnrpt un,lcr S(l I./')o",", .Slzl t"l u-*., )(Y L-cffi. TOBf,!f,ILI;OMPJISAIION DEI;IAXa.IIIIN I hcrcby ofinmunds pcMlty oi psJlry onc ofrhc followinB d(lomrions: -l hrvc will nEinrain ! Ccnmcorc of Con*nr to Sclllnsurc for *olkcrs .omocnsur ioo. rs pruvidcdforhysccrion37mof r liht Cod., lor $. pdL,mRâ‚¬ ol rhc w.rt td ehkh rh. Frnn is issucd. -l nurc and will mainhin *orkcc compcnsario. insurance, $ rcquiod by s(rion l70o ol rhc ljbor Codc, for lhc p.rii,rmnce of rhc work {m *hi:h r his }crmir is n$.d. My wo si ompensrion insurec .,rM ,rn p. cy 6unb.r m: /t5.cnily lhri if rhc |xrronMkc oflhcwork hr which lhn 0crmir n i\ucd.l sholltrol cnrpby rny pc^on inany umr $ !s'o bccom suhicr to rhc sorkcn compcn\lrion ln*s olCalirbmia, and lsft rh,r irl :buld tt.nft shitr to lhc \$rkc.onlpcnsrtn,ntmvhio.solSccrtrnlTmotrncljtnrCodc.l\hrll.r(,nh*irh.onPlyBirhrho$ri.visions \lARNINC: ljallurc lo scurc *orlc6 .1Dp.n\rrnnr coE civil lnNs np ro onc hunJrcl rho!$nd Jolhn lSlll).(xxr) S.cri,)n 1076olrhc lrh,('{x1., inrcrcd rJ anonrJ_ s frs *", 'slzl tt n,,,u".,F IIECI,AIAII!]N I hc6hy dmrn mdo p.mlry ot p.rjury lhar Lm lia.$d undr FDvision of Chofls 9 (@nmrcins sirh S.{rbo 7()o0} of oivision l of rhc Busituss and Pm{csrionq Cod.. u.d oy li.eo\e is i. lull for.c !d cffNr. Li..ns NuntErl caNsralsrcNu ulcncEN(r I hcEht alrtm undc. rEmlry oi pc,jury rhxl rhcrc t ! consltoction lcndins r8cn.y rtn rh. p.rroffuct or lh. work lor *hich lhn pcflril i issucd (s(. .1097. civ. c.) -l cenir lhol lhc fâ‚¬nctll rcsulalio.s rcsldi.s lstxsto\ rcnhlllarc .or rrpltabL 'o rhis,,mitr. A'rln iry rh.l I h,vc rcad this amli.arhtr and sllrc rhar Ih. !bo$ inform0ri.,t s comcr I lgr to c6mpl, wtrh .ll ciry snd counly .nlinrn.cs md Slarc tjws Ehlin8 lo builditrs consrrucrion, ard h.rcb) ourlFrA rcI'(scnrsr rvcr frhkC ,and Coun'ylocnl6uronlh.rh c ftFrnncd nml,.ny hr rlsD.d'on Durn s:-, . Iffil:#;1"'i' " -Wd,tu4oo-i4 *,. - sfi/ r s ,"*u*,,.",,n,,, X/â‚¬â‚¬l-tsEo;l S a r,c j erS Site-Work Underground Pole Bases Light Standards Spas, Pool, Fountains Signs (monument) Lile Salety /Low Voltage Fire Alarm / Dampers Building Under Slab / Floor Bonding / Grounding i UFER Translormers Torqueinq Air Conditioners Roof Top Equipment Factory Wired Unil Walls (Conduit) Walls (Rouqh) Ceilings (Hard & Soflit Rouqh Ceilings (T-Bar Rouqh)rl lr/eter Release 5 r1 t6 J&Ju3Y Rough S il|llif.tl*-Ir- FINAL (t.. f/31- Notes, Remarks, Etc I to o t r 4 I L I --t Communications Cable Sub-Panels Service Meter \ID {Lf,ndq'r Addrcs: - A.[[IJCANL!ECLI[6.II!] I tlrbydimnund.r Fn.lr, ofp.rjury o.c otthc iollowin8 dcclrr ions D.d,liri Pdnirs Asbcd.r Norificmion Ftdcril Rcguhrions (Tnb40. P3f,6) _RquiN lrrrcrof Mril-@ri0n tt MAYOR L4iguelA. Pulido MAYOR PRO TEM Michele Martinez COUNCILMEI\,1BERS P. David Benavides Vicente Sarmiento Jose Solorio SalTinajero Juan Villegas CITY OF SANTA ANA PLANNINC & BUILDINC AGENCY 20 Civic Center Plaza P.O. Box 1988 . Santa Ana, California 92702 www.santa ana.org/pba NOTICE TO PROPERTY OWNER An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified at r{{}5 w w/s rta P/ %t*to 4wa c/? 9a-70 ACTING CITY MANAGER Gerardo l\4ouet CITY ATTORNEY Sonia R. Carvalho CLERK OF THE COUNCIL lvlaria D. Huizar Y We are providing you with an Owner-Builder Acknowledqment and lnformation Verification Form to make you aware of your responsibilities and possible risk you may incur by having this permit issued in your names as the Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of each provision, signed, and returned this form to us at our official address indicated. An agent of the owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting authority. OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATON SANTA ANA CITY COUNCIL mou do@santa-ana.o.o Mayor Pro Tem, Ward 2 mimarlinez@sania-ana.oro V ce.te Samienlo vsamlsnlo@sanra-ana oro so oroOsanla-ana oro dbe.avdesrOsanra ana.oro villeoas@sania-ana oro sl naiero@sania-ana.oro Dear Property Owner: DIRECTIONS: Read and initial each statement below to signify you understand or verify this information. l. a 1 I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-Builder" building permit that erroneously implies that the property owner is providing his or her own labor and material personally. l, as an Owner-Builder, may be held liable and subject to serious financial rjsk for any injuries sustained by an unlicensed person and his or her employees while working on my property. My homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. 14 -3 2. I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed Contractor to assume this responsibiljty. dr-La. t understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed Contractor and having the perm jt filed in his or her name instead of my own. A-5 +. t understand Contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. H S S. t understand if I employ or otherwise engage any persons, other than California licensed Contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an "employer" under state and federal law. tLLA. I understand if I am considered an "employer' under state and Federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment compensation of each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. i4 -5 Z. t understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless a//work is performed by licensed subcontraclors and the number of slructures does not exceed four wilhin an! calendar years, or all of the work is performed under contracl with a licensed general building Contractor. A_LA I understand as an OwnerBuilder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent construction defects in the workmanship or materials. A-.: g. t understand I may obtain more information regarding my obligations as an "employer" from the lnternal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of lndustrial Accidents. I also understand I may contact the California Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.qov for more information about licensed contractors. A $ lO.l am aware of and consent to an Owner-Builder building permit applied for in my name, and understand that I am the party legally address: and fi nancially res ponsr or propos ed construct activity at the followirLL4t. L C(() A - 5 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner-Builders as well as employers. A_!12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. lf you contract with someone who does not have a license, the Contractors' State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. lt is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. lf you obtain a permit as Owner-Builder and wish to hire Contactors, you will be responsible for verifying whether or not those Contractors are properly licensed and the status of their workers' compensation insurance coverage. Before a building permit can be issued, this form must be completed and signed by the property owner and returned to the agency responsible for issuing the permit. /Vote.'A coDv of the DroDertv nerts dri ver's license form notarization, or other verification acceptable to the aqencv is required to be presglI@ll when the permit is Signature of Property Owner Date Print name of Owner F AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and flle the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work) Project Location or Address; Address of Authorized Agent:_ Phone Number of Authorized Agent: I declare under penalty of perjury that I am the property owner for the address listed above and I personally lllled out the above information and certify its accuracy. Date Print Name of Owner: Note: A copy of the owner's driver's license, form notarization, or other verification acceptable to the agency is required to be presented when the permit is issued to verify the propedy owner's signature. SANTA ANA CITY COUNCiL mpu dolAsanla ana oro Mayor Pro Tem Ward 2 mimadinez@sanla-ana.oro vsarmrenro@sanla-ana oro is9!9!9@se!E:cEgg dbe.6v'des@sanla-ana o.o v eoasaasanla ana.oro slrnaiero@sanla-a.a.oro issued to verifu the propertv owner's signature. Name of Authorized Agent: _ ProDertv Owner's Sionature: